中国神经再生研究(英文版) ›› 2021, Vol. 16 ›› Issue (1): 172-178.doi: 10.4103/1673-5374.286974

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

干细胞治疗糖尿病视网膜病变的研究热点:文献可视化分析

  

  • 出版日期:2021-01-15 发布日期:2020-11-26
  • 基金资助:

    吉林省自然科学基金项目(20200201495JC),吉林省卫生技术创新项目(2017J089)

Insights into stem cell therapy for diabetic retinopathy: a bibliometric and visual analysis

Xiang-Jun Li1, Chun-Yan Li2, Dan Bai1, Ying Leng1, *   

  1. 1 Department of Ophthalmology, Affiliated Hospital of Beihua University, Jilin, Jilin Province, China;  2 Department of Endocrinology, Affiliated Hospital of Beihua University, Jilin, Jilin Province, China
  • Online:2021-01-15 Published:2020-11-26
  • Contact: Ying Leng, MD, lengyingeye@126.com.
  • Supported by:
    This study was supported by the Natural Science Foundation of Jilin Province of China, No. 20200201495JC; Jilin Province Health Technology Innovation Project, No. 2017J089. 

摘要:

有研究证实干细胞参与了糖尿病视网膜病变的发生与发展,但相关机制目前仍不明确。文章采用Citespace软件对Web of Science (WOS)核心合集数据库近20年的干细胞治疗糖尿病视网膜病变相关552篇文章进行研究热点的可视化分析发现:(1) 基于552个文献的参考文献共被引分析可划分为14个聚类,以聚类#0干细胞领域为例,从2009-2013涌现了一些高被引的里程碑研究。如内皮祖细胞与糖尿病视网膜病变的关系及治疗前景逐渐得到学者们的充分关注,在多种视网膜血管病动物模型中验证了脂肪来源的干细胞有分化为稳定视网膜血管周细胞的能力,这些研究都为干细胞后续研究提供了参考依据;(2) 基于552个文献的热点关键词分析发现,近20年干细胞和内皮祖细胞对糖尿病视网膜病变影响的基础研究文章相对较多,研究内容主要涉及血管内皮生长因子表达、血管再生、氧化应激和炎症反应变化等方面;(3) 基于552个文献的关键词爆发分析发现,2001-2012年,此阶段的主要关注点聚焦在如何促进血管新生的基因和细胞学研究方面,如各种生长因子基因表达特征的研究较多;2014-2020年,小鼠模型已被公认为糖尿病性视网膜病变的成熟动物模型,最新研究多关注糖尿病动物模型的黄斑变性、黄斑水肿、神经变性和炎症变化的相关病理学改善方面;(4) 上述数据显示,目前国际上关于干细胞治疗糖尿病视网膜病变的公认权威文献多在基础研究阶段,已有的临床研究质量较低,证据级别不足,还未得到普遍的临床认可。在干细胞移植过程中,有关干细胞的异质性、细胞传送、向受损伤组织有效的归巢仍是主要难题。但一些有潜力的如多能干细胞、视网膜色素上皮细胞、骨髓间充质干细胞和内皮祖细胞治疗糖尿病视网膜病变的临床试验均在进行中,希望未来能出现高质量的临床证据,以促进临床转化。

https://orcid.org/0000-0003-3504-0101 (Ying Leng)

关键词:

干细胞, 糖尿病, 视网膜, 黄斑, 祖细胞, 上皮细胞, 可视化分析

Abstract: Stem cells have been confirmed to be involved in the occurrence and development of diabetic retinopathy; however, the underlying mechanisms remain unclear. In this study, we used Citespace software to visually analyze 552 articles exploring the stem cell-based treatment of diabetic retinopathy over the past 20 years, which were included in the Web of Science Core Collection. We found the following: (1) a co-citation analysis of the references cited by all 552 articles indicated 15 clusters. In cluster #0, representing the stem cell field, some highly cited landmark studies emerged between 2009–2013. For example, endothelial progenitor cells and diabetic retinopathy gradually received the full attention of scholars, in terms of their relationship and therapeutic prospects. Some researchers also verified the potential of adipose-derived stem cells to differentiate into stable retinal perivascular cells, using a variety of animal models of retinal vascular disease. All of these achievements provided references for the subsequent stem cell research. (2) An analysis of popular keywords among the 552 articles revealed that, during the past 20 years, a relative increase in basic research articles examining stem cells and endothelial progenitor cells for the treatment of diabetic retinopathy was observed. The contents of these articles primarily involved the expression of vascular endothelial growth factor, vascular regeneration, oxidative stress, and inflammatory response. (3) A burst analysis of keywords used in the 552 articles indicated that genetic and cytological research regarding the promotion of angiogenesis was an issue of concern from 2001 to 2012, including several studies addressing the expression of various growth factor genes; from 2014 to 2020, mouse models of diabetic retinopathy were recognized as mature animal models, and the most recent research has focused on macular degeneration, macular edema, neurodegeneration, and inflammatory changes in diabetic animal models. (4) Globally, the current authoritative studies have focused on basic research towards the stem cell treatment of diabetic retinopathy. Existing clinical studies are of low quality and have insufficient evidence levels, and their findings have not yet been widely accepted in clinical practice. Major challenges during stem cell transplantation remain, including stem cell heterogeneity, cell delivery, and the effective homing of stem cells to damaged tissue. However, clinical trials examining potential stem cell-based treatments of diabetic retinopathy, including the use of pluripotent stem cells, retinal pigment epithelial cells, bone marrow mesenchymal stem cells, and endothelial progenitor cells, are currently ongoing, and high-quality clinical evidence is likely to appear in the future, to promote clinical transformation.

Key words: diabetes, diabetic retinopathy, epithelial cells, macula, progenitor cells, retina, stem cells, visual analysis